Outcome of surgical treatment for recurrent pyogenic cholangitis: a single-centre study

Abstract

Background: Recurrent pyogenic cholangitis (RPC) is still a common disease in East Asia. The present study reviews the operative results for this disease in a single centre.

Methods: The records of 85 patients who underwent surgical treatment for RPC from August 1995 to March 2008 were retrospectively reviewed.

Results: Patients included 35 men and 50 women with a median age of 61 years. Types of surgery included: hepatectomy (65.9%); hepatectomy plus drainage (9.4%); drainage alone (14.1%), and percutaneous choledochoscopy (10.6%). There was no operative mortality. Complications occurred in 40% of patients and half the complications involved wound infections. The overall incidences of residual stone, stone recurrence and biliary sepsis recurrence were 21.2%, 16.5% and 21.2%, respectively, over a median follow-up of 45.4 months. The drainage-alone group and percutaneous choledochoscopy group had higher incidences of residual stone, stone recurrence and biliary sepsis recurrence. In hepatectomy patients, regardless of whether or not a drainage procedure had been performed, rates of residual stone, stone recurrence and biliary sepsis recurrence were 15.6%, 7.8% and 9.4%, respectively, over a median follow-up of 42.7 months.

Conclusions: Hepatectomy is safe and yields the best treatment outcome for RPC. It should be considered as the treatment of choice for suitable patients with RPC.

Keywords: choledoch oscopy; hepatectomy; hepaticojajunostomy; hepatolithiasis; intrahepatic stores; recurrent pyogenic cholongitis.

Figure 1

Computed tomography revealed multiple intrahepatic ductal stones and ectatic intrahepatic ducts compatible with recurrent pyogenic cholangitis